Predictive Factors of Loftus et al for an Appendiceal Tumor in a Patient Presenting with Appendicitis

Patient selection: adult >= 18 years of age with appendicitis

Outcome: identification of an appendiceal tumor

Identification of a suspicious mass on imaging studies or at surgery (note for Table 3) was most predictive.

Factors predictive of an appendiceal tumor from the multivariate model:

(1) age >= 50 years

(2) steroid or immunosuppressant use

(3) absence of migratory right lower quadrant pain

(4) phlegmon identified on CT scan

Additional factors to consider from the univariate analysis:

(1) Charlson comorbidity index >= 3 (colinear with age and steroid/immunosuppression therapy)

Appendectomy should be considered over nonoperative management for a patient when predictive findings are present.